Management of cardiogenic shock complicating acute myocardial infarction: A review

Shah, Ashish; Puri, Rishi; Kalra, Ankur

doi:10.1002/clc.23168

Cited by 56 publications

(53 citation statements)

References 90 publications

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“…Furthermore, supportive drug treatments with inotropes and vasopressors bring no benefit to patients. Cardiologists hope that mechanical circulatory support will improve clinical outcomes in this population . The intra‐aortic balloon pump (IABP) becomes the first and most widely used device due to its ability to reduce afterload and improve coronary blood flow .…”

Section: Introductionmentioning

confidence: 99%

“…Cardiologists hope that mechanical circulatory support will improve clinical outcomes in this population. 3,4 The intra-aortic balloon pump (IABP) becomes the first and most widely used device due to its ability to reduce afterload and improve coronary blood flow. [4][5][6][7] However, recent meta-analyses and the landmark randomized controlled trial did not show a beneficial effect of IABP in patients with AMI complicated by CS.…”

Section: Introductionmentioning

confidence: 99%

“…3,4 The intra-aortic balloon pump (IABP) becomes the first and most widely used device due to its ability to reduce afterload and improve coronary blood flow. [4][5][6][7] However, recent meta-analyses and the landmark randomized controlled trial did not show a beneficial effect of IABP in patients with AMI complicated by CS. [8][9][10][11] Thus, the recommendations of IABP therapy have been reduced both in the American and European guidelines.…”

Section: Introductionmentioning

confidence: 99%

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Timing of initiation of intra‐aortic balloon pump in patients with acute myocardial infarction complicated by cardiogenic shock: A meta‐analysis

Cui

Lyu

Hong

et al. 2019

Clinical Cardiology

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Background For patients with acute myocardial infarction (AMI) complicated by cardiogenic shock (CS) undergoing primary percutaneous coronary intervention (PCI), the optimal timing of the initiation of intra‐aortic balloon pump (IABP) therapy remains unclear. Therefore, we performed the first meta‐analysis to compare the outcomes of IABP insertion before vs after primary PCI in this population. Methods Electronic databases of PubMed, EMBASE, and Cochrane Library were comprehensively searched from inception to April 1, 2019, to identify the eligible studies. The main outcomes were short‐term (in‐hospital or 30 days) and long‐term (≥ 6 months) mortality. In addition, pooled analysis of risk‐adjusted data were also performed to control for confounding factors. Results Seven observational studies and two sub‐analysis of randomized controlled trials involving 1348 patients were included. Compared to patients inserted IABP after PCI, patients who received IABP therapy before primary PCI had similar risks of short‐term (odds ratio [OR] 0.88, 95% CI 0.49 to 1.59) and long‐term (OR 0.99, 95% CI 0.58 to 1.68) all‐cause mortality. Moreover, a pooled analysis of risk‐adjusted data also found similar effects of the two therapies on short‐term (OR 0.65, 95% CI 0.34 to 1.25) and long‐term (OR 0.68, 95% CI 0.17 to 2.72) mortality. Besides, no significant difference was found between the two groups with respect to reinfarction, repeat revascularization, stroke, renal failure, and major bleeding. Conclusions The timing of the initiation of IABP therapy does not appear to impact short‐term and long‐term survival in patients with AMI complicated by CS undergoing primary PCI.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Timing of initiation of intra‐aortic balloon pump in patients with acute myocardial infarction complicated by cardiogenic shock: A meta‐analysis

Cui

Lyu

Hong

et al. 2019

Clinical Cardiology

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“…Ischemic heart disease (IHD) is a major cause of mortality and morbidity worldwide [1]. The estimated annual incidence of heart attack caused by myocardial infarction is 865 000 new and recurrent attacks, and the prevalence and mortality due to MI increases with age [2,3]. The prognosis of acute myocardial infarction (AMI) and ischemic cardiomyopathy (ICM) remains poor despite significant advances in medical therapy and revascularization strategies [4].…”

Section: Introductionmentioning

confidence: 99%

Neutrophil Gelatinase-Associated Lipocalin2 Exaggerates Cardiomyocyte Hypoxia Injury by Inhibiting Integrin β3 Signaling

Geng

et al. 2019

Med Sci Monit

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Background The neutrophil inflammatory protein, lipocalin-2 (NGAL), is elevated in certain forms of cardiac hypertrophy and acute heart failure. However, the specific role of NGAL in cardiac hypoxia injury is unclear. This study aimed to elucidate the functional role of NGAL in cardiomyocyte hypoxia injury. Material/Methods Neonatal rat cardiomyocytes were transfected with adenovirus [(Ad-NGAL] to overexpress human-NGAL and then were exposed to hypoxia for 24 h to establish a hypoxia model. Cell inflammation was detected by RT-PCT and ELISA assay. Cell apoptosis was detected by TUNEL assay. Oxidative stress was also detected by commercial kits. Results An increased inflammatory response, apoptosis, and augmented oxidative stress were observed after exposure to hypoxia, while NGAL overexpression in cells increased the expression and release of inflammatory cytokines. NGAL overexpression also increased the number of apoptotic cells and the imbalance of Bax/Bcl-2 protein expression. Moreover, NGAL overexpression increased the levels of reactive oxygen species and oxidase activity, but reduced anti-oxidase activity. Mechanistically, we found that NGAL decreased the expression of integrin β3, but not the expression of integrin avβ3 and avβ5, thus inhibiting the downstream protein AKT. When we used the constitutively activated AKT overexpression adenovirus to activate AKT, the deteriorated phenotype by NGAL was counteracted. Conclusions NGAL can directly affect cardiomyocytes and cause cardiomyocyte deteriorated hypoxia injury through inhibiting integrin β3 signaling.

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“…Infarct-related heart failure leads to an increase in the long-term comorbidity and mortality, which often counterbalances the benets which has been from the timely 5 reperfusion . A fraction of patients with STEMI presenting with normal hemodynamic parameters may deteriorate post the primary 6 PCI following they may develop CS . Previous studies have shown that around 50% of nal infarct myocardium is caused by the reperfusion 7 injury (RI) which occurs following PCI .…”

mentioning

confidence: 99%

Utility of Shock Index for Prediction of Cardiogenic Shock Developed During Primary Percutaneous Coronary Intervention

Bansal

Gautam

Sharma

et al. 2020

ijsr

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Introduction: Cardiogenic shock (CS) is a distinct clinical entity with a high morbidity and mortality. CS after primary PCI usually portends a bad prognosis and needs prompt recognition. Shock Index (SI) serves as one of the valuable non-invasive marker for development of CS. Methods: This was a single centre prospective observational study wherein patients with ST elevated myocardial infarction (STEMI) were enrolled. In all these patients, prior to performing the coronary angiogram, shock index (SI) was calculated as heart rate (HR) divided by SBP on admission. Primary outcome was the occurrence of CS during the period of hospitalisation post primary PCI. Study population was divided into two groups: Group 1: patients with ACS without CS and Group 2: patients with ACS with CS. Results: A total of 240 patients were included in the study of whom 19 (7.9%) developed CS. Patients with CS (Group 2) had a significantly higher frequency of anterior wall MI, prior history of stroke, heart rate and a lower left ventricular ejection fraction. Multivariate logistic regression analysis revealed pre-procedure SBP, pre-procedure HR, Killip class, serum creatinine and Shock Index to be the independent predictors of developing CS post primary PCI. ROC curve showed that SI (AUC: 0.8113 ; P=0.004) had a better predictive ability as compared to pre-procedural heart rate (AUC: 0.7111; P=0.01) and pre-procedural SBP (AUC: 0.7582; P=0.001) for prediction of CS post primary PCI. Conclusion: SI is a promising tool to detect presence of shock post primary PCI in STEMI patients.

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Management of cardiogenic shock complicating acute myocardial infarction: A review

Cited by 56 publications

References 90 publications

Timing of initiation of intra‐aortic balloon pump in patients with acute myocardial infarction complicated by cardiogenic shock: A meta‐analysis

Timing of initiation of intra‐aortic balloon pump in patients with acute myocardial infarction complicated by cardiogenic shock: A meta‐analysis

Neutrophil Gelatinase-Associated Lipocalin2 Exaggerates Cardiomyocyte Hypoxia Injury by Inhibiting Integrin β3 Signaling

Utility of Shock Index for Prediction of Cardiogenic Shock Developed During Primary Percutaneous Coronary Intervention

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